Failed IVF: Why Does it Happen? What Next?

Failed IVF: What do I do Next?

A failed IVF cycle could put couples under a lot of mental discomfort, anger and confusion. Modern science provides great opportunities to treat infertility, but failures do happen, due to a variety of factors.

In most cases, these factors can be identified and help improve the chances of a successful pregnancy in subsequent IVF cycles. Let us look at how to cope after a failed IVF cycle, IVF failure reasons and the options after a failed IVF.

How to Cope with a Failed IVF Cycle?

The most important thing to do after a failed IVF cycle is to understand why the failure happened. Your fertility expert will be able to explain the causes of IVF failure correctly. Simultaneously, your fertility counsellors will also be available to listen to your difficulties and offer advice.

• Avoid the Blame Game – You should understand that medical science can go wrong sometimes and there is no need for you to blame yourself or your spouse. One failed step does not mean that there are no other options. You should instead comfort each other and stay positive.
• Stay Aware – Gather information on possible remedies and treatment methods that can improve your chances of pregnancy. There are multiple methods which can treat infertility and you can always choose options more suited to your medical history and requirements.
• Communicate with Your Friends & Family – Speak to friends who have undergone similar experiences or whom you can trust. There are several online communities that offer support and success stories of people who had similar IVF cycle failure.
• Try to Relax – IVF treatment can be emotionally overwhelming. On top of the medical procedures, receiving negative outcomes can add to your distress. If you have experienced a failed IVF, take a break from treatments and reduce your stress. You can go on a small vacation, indulge in hobbies, engage in sports and fitness. The idea is to be optimistic and take a break before you look out for options after failed IVF.

What are the Causes of IVF Failure?

Nearly 2,16,000 IVF cycles were performed in India in the year 2019. On average, only 40% of all cycles lead to successful pregnancies. Despite the advancement of technology, there are multiple IVF failure reasons.

Let us briefly go through the steps involved in an IVF procedure.

• Hormonal injections are given to the female to induce ovulation.
• Eggs are retrieved from the female after sufficient medication.
• Sperm is collected from the male partner.
• Eggs and sperm are fused under carefully monitored lab conditions to form an embryo.
• The resulting healthy embryo is implanted in the uterus of the female.

The cycle could have failed at various points of this journey due to one or more of the following causes.

• When there is no egg to be retrieved from the female
• When there are very few eggs that could be retrieved
• When the quality of eggs retrieved was poor due to age or medical history
• When the sperm is of poor quality
• When an embryo could not be formed in the lab

Even beyond these cases, when a healthy-looking embryo has been placed in the uterus, there are chances of failure. Contrary to popular belief, not all embryos that are placed in the uterus lead to pregnancy.

Such a failure could be due to personal factors, lifestyle factors, or in some cases, laboratory conditions.

Personal Factors Causing Failed IVF Cycle

• Age : With age, the number of eggs that a female can produce comes down significantly. Women above the age of 35 have fewer eggs that can be retrieved and even those retrieved can be of poor quality.
• Chromosomal Abnormalities : A common reason for the failure of pregnancy, natural or IVF, is due to abnormalities in the chromosomes of the parents. Even a chromosome that looks healthy under the microscope could have abnormalities. Thankfully, assisted reproductive techniques have progressed and Pre-implantation Screening (PGS) can help in selecting embryos which do not have any chromosomal abnormalities.
• Sperm Factor : A study finds that higher sperm DNA fragmentation can lead to higher miscarriages. This can be cured by varicocele repair, lifestyle changes and by eating a heavily nutritious diet rich in antioxidants.
• Uterine Cavity Issues : When the shape of the uterus does not provide an environment conducive for the embryo to implant itself, the cycle could fail. Also, when the uterus is not able to nourish the embryo to sustain growth, the implantation fails and the embryo does not lead to a pregnancy.
• PCOS : Polycystic Ovary Syndrome is a hormonal disorder that affects the release of eggs. PCOS has been shown to heighten chances of a pregnancy loss but proper diagnosis and administration of drugs can minimise the risk of pregnancy loss.
• Thin Endometrium : The embryo implants itself on a thin layer of cells called the endometrium. If the endometrium has a thickness below 7mm, the embryo fails to attach itself to the mother and leads to a failed IVF cycle. Thin endometrium is caused due to a sedentary lifestyle – when blood is not circulated well in the uterus – or due to uterine fibroids or hormonal imbalances.
• Autoimmune Diseases : An autoimmune disease is when a person’s immune system mistakenly attacks its own body parts. Similarly, when an embryo is placed in the uterine cavity, the immune system could consider it as a foreign body and cause an IVF cycle failure.
• Diabetes and Hypothyroidism : Studies have shown that women with diabetes (when blood glucose levels are too high) and hypothyroidism (when the body is not able to generate sufficient thyroid) are at a higher risk of failed pregnancies. A proper diet and a check on blood glucose and thyroid levels can improve your chances of success in the next cycle.

Lifestyle Factors Causing Failed IVF Cycle

• Smoking and Excessive Alcohol Consumption : Women are advised to stop smoking and avoid excessive consumption of alcohol prior to IVF cycles and even in the case of normal pregnancies. These two practices have been shown to affect pregnancies.
• Obesity : Obesity, in other words having a high Body Mass Index (BMI), has been shown to cause higher rates of miscarriage in the first trimester. Trying to reduce your weight before the next IVF cycle could improve chances of a successful pregnancy.
• Stress : Higher levels of stress can increase the chance of IVF failure by nearly 3 times. Stress releases a hormone called cortisol which triggers a hormonal imbalance. This makes the body less suitable for implantation. Calming down in the next IVF cycle can help you.

Finally, it is possible that the laboratory conditions, in which the egg and sperm were fertilised, were not maintained at the required temperature or improper handling by the lab technician or in some cases, poor quality technology and equipment.

High-quality laboratory conditions, qualified technicians and world-class technology is offered by very few IVF clinics.

What are the Options After Failed IVF?

A failed IVF cycle does not mean the end of the world. Assisted Reproductive Technologies (ART) have a success rate of 40% but with multiple cycles, the chances of pregnancy increase. This is because doctors can identify what went wrong and suggest different treatments accordingly.

Let us start with changes that you can implement in your life to better the chances of success in the next cycle.

• Eat Healthily : In the two months prior to your next IVF cycle, ensure that you have a balanced diet. Get more vitamins and minerals in your diet. Cut down on caffeine and sugars.
• Regular Exercise : A healthy mind lives in a healthy body. Keep your body fit with moderate amounts of exercise. Avoiding a sedentary lifestyle improves blood flow and keeps you more positive and confident.
• Reduce Stress : Stress during infertility treatment is common amongst most couples. Lower stress levels increase chances of conception.
• Keep a Check on Diabetes and Hypothyroidism : Be proactive and maintain your blood glucose and thyroid levels. If these levels are stable, failure due to hormonal imbalance can be avoided.

There are a few add-on medical procedures that can minimise the chances of a failed IVF cycle. Consult with your doctor about opting for these procedures.

• Preimplantation Genetic Screening (PGS) : The embryos formed under laboratory conditions are checked for any chromosomal abnormalities. With this additional step, you can ensure that an embryo without any abnormalities is placed in the uterus. Other Assisted Reproductive Technology methods can also be implemented as options after failed IVF cycle if they boost the chances of success.
• IntraCytoplasmic Sperm Injection (ICSI) : When the sperm count or motility is low, the sperm will not be able to fuse with an egg. To aid this process, sperm is injected directly into the egg in the laboratory to create an embryo. ICSI is an additional step in the IVF process when there are issues with the sperm retrieved from the male partner.
• Laser Assisted Hatching : To help the embryo implant in the uterus, a small opening is created in the outer layer of the embryo. If you have been facing implantation issues, assisted hatching can provide a solution to your problem. If after multiple IVF cycles, you are unable to conceive, it might be due to a mix of factors from age to the egg and sperm quality. In such a case, the doctor might suggest the use of donor sperm or donor eggs to put you on your way to become a parent.

Summary

Failed IVF cycles can be devastating but you should not lose hope. This is the time to stick together as a couple. Fertility advancements can provide a way to solve the causes of IVF failure.

Your fertility specialist will help you understand the options after failed IVF so that you can make an informed decision. Subsequent cycles are always less pressurising because you already know what an IVF cycle involves.

Failed IVF cycles may delay but cannot stop you from becoming a parent. There are a range of services which can be utilised in ensuing attempts. You must understand your condition better, not lose hope and look ahead to a satisfying life as a parent.

For more information on infertility treatment options, visit Birla Fertility & IVF.